This report is a useful resource for couples pursuing fertility treatment. Success rates are significantly different between programs. When you go through an IVF cycle you are not getting the same treatment at every program.

It’s not like going out and buying a Jeep:

• If there is a Jeep dealer closer to home, or a little cheaper – then a Jeep is a Jeep, so buy it there
• However, IVF is not a commodity
• IVF at one clinic may result in an average success rate of 25% while at another clinic it might be 60% for the same age group
• In vitro fertilization at “Clinic A” does not equal IVF at “Clinic B” – so do your research

Our IVF success rates
Our egg donation success rates

The clinics must turn in their data every year (to SART and the CDC)  in November for the IVF cycles performed during the previous calendar year. SART then takes a few months to prepare the report and publish the results on the web.

The CDC (Centers for Disease Control and Prevention), a US government agency, also publishes annual IVF success rate reports

• However, release of the CDC report is delayed by about 8 to 10 months after the SART report
• The CDC’s report is more comprehensive and includes more clinics with additional analysis of data beyond clinic success rates
• The drawback of the CDC report is the additional delay before publication

To go to the 2009 SART report and check IVF live birth success rates for any SART member clinic, follow these steps:

• Click this link: www.sart.org
• Click on the orange button “IVF Success Rate Reports”
• Click on the state that you want on the US map
• A list of all SART member clinics in that state will come up
• Click on the clinic you want to see results for
• Click next to “ART Data Report” (at the bottom) and that clinic’s IVF success results for 2009 will come up

Study the report in the area relevant to you – own eggs and age 40, or donor eggs, etc. If a clinic is missing from the SART or CDC reports it is probably a bad sign. Find out why they did not report – or go elsewhere. Buyer beware.

If you check the success rate information for a clinic you are considering for treatment and find that they are low compared to national averages or other clinics in your area – go to a clinic with higher success rates. It would likely increase your chance to have a baby with IVF.

A comparison of clinic success rates may not be meaningful because patient medical characteristics, treatment approaches and entrance criteria for ART may vary from clinic to clinic.

Richard Sherbahn, MD is a fertility doctor practicing in the Chicago, Illinois area. Connect with me on Google+

Mail | Web | Google+ | More Posts

I see a lot of couples that fail IVF at other in vitro fertilization programs and then come to us for their 3rd or 4th or 5th IVF attempt. They seek an IVF clinic that can give them a better outcome. Recently I’ve been hearing a similar story from couples that have failed at certain other IVF clinics in the Chicago area.

What to do if your first IVF cycle fails

These couples asked their fertility doctor why our clinic (Advanced Fertility Center of Chicago) has higher IVF and donor egg success rates than they have. They have been told that “Dr. Sherbahn cherry picks the best patients and does not treat patients with a low chance to get pregnant”. In other words they are accusing me of turning patients away with a low chance for pregnancy in order to cherry pick only the best patients and thereby artificially pump up our success rates.

It is a total crock. Patients that fail IVF again and again are likely to do IVF related research on the internet. They will find the CDC and SART websites where they can see if another clinic in their area has better pregnancy rates than the program where they failed.

How to research IVF success rates at US clinics

• People are often motivated enough at that point to drive farther to a clinic that might give them a better chance for success.
• Therefore, people that fail and often have egg quality problems or other issues holding back their success will tend to switch to programs with higher success rates after they have done research.
• This results in programs like ours with higher than average success rates getting more patients with previous failures - which tend to be the most difficult cases.
• As a result, we will get relatively fewer “easy” cases

We do not send patients away or tell them we will not do IVF on them unless they are menopausal or otherwise clearly have a very low chance of success. I believe that if the couple has about a 5% or better chance of success and has been educated about their chances – we should allow them to cycle here. Taking patients with a 5% chance of success is certainly not “cherry picking”

• Some fertility specialists with big egos and poor quality IVF programs either just can’t accept the fact that their IVF programs aren’t very good – or perhaps they’re in denial and really believe that other programs have better success rates because they “cherry pick”
• Either way it’s pitiful

The clinics with low success rates often say that the reason IVF success rates are different between clinics is because:

• Patient populations are different between clinics
• Criteria for canceling IVF stimulation cycles are different
• The number of embryos transferred is different
• The percentage of single embryo transfer cases performed is different

Because these things can be different between clinics they claim that comparing success rates is not valid. However, just because comparisons are not perfect does not mean that comparisons should not be made. We cannot expect 100,000 IVF patients coming to 500 clinics across America to all have equal potential for a successful pregnancy. Every case is different, every egg and every sperm is unique and even the uterus can vary to some extent.

• However no clinic gets all the good cases, and no clinic gets only bad cases
• A mix of patients will present themselves to every clinic for treatment

If we look at success rates of clinics in the US according to the CDC and SART 2008 data sets (see graph below), we see a range of live birth success rates for cycles using fresh donor eggs from 25% to 81% per transfer. The national average for 2008 was 55% per transfer.

Our donor egg success rates

Egg donation cycles should be homogeneous with little chance for “cherry picking”. This is why I use donor success rates here for comparison.

• Egg donors are generally quite young – usually under 35 years old
• The recipients tend to have an a normal uterus – a low percentage of patients have uterine problems
• It is therefore unlikely that uterine problems would be a significant factors affecting a clinic’s overall egg donation success rates
• So how can we explain the dramatic differences in success rates between clinics doing egg donation?
• The differences are not due to the quality of the donor’s eggs or the recipient’s uterus or the number of embryos transferred
• These variations in success rates are a result of differences in treatment protocols and quality control in the IVF labs

Execution from beginning to end is critical:

• Proper regulation of IVF stimulation of the egg donor and the recipient properly
• Performing the egg retrieval procedure expertly and at the right time
• Many variables exist in the in vitro fertilization laboratory which impact the quality of the embryos
• Choosing the proper high quality embryos for transfer
• Properly performed embryo transfer using ultrasound guidance is critical for a good outcome

Can there be differences in patient selection and other factors for egg donation cycles?

• Yes

Will these differences have a substantial impact on success rates?

• No. This is why egg donation is an excellent model for comparing IVF clinics.

Consumers of fertility services should go to the CDC and SART websites and study egg donation success rates of the programs that they might consider going to for IVF or for egg donation. This is a way to compare IVF clinics which pretty much eliminates the “cherry picking issue.

• So to the fertility doctors that accuse other doctors with higher success rates of “cherry picking”, I say:
• Stop whining and put your energy into fixing the problems in your own IVF program instead of making excuses for why another clinic is doing better than you are.
• Or consider quitting IVF and focus on artificial inseminations and infertility surgery

Richard Sherbahn, MD is a fertility doctor practicing in the Chicago, Illinois area. Connect with me on Google+

Mail | Web | Google+ | More Posts

There are two websites that report IVF success rates annually to the public:

• CDC website (Centers for Disease Control and Prevention)
  • CDC is a US government agency
• SART website (Society for Assisted Reproductive Technology)
  • SART is an organization dedicated to the practice of IVF in the US
• Links to these sites that report IVF success rates

The CDC IVF Success Rate Report for 2008 report has not yet been released. In vitro fertilization statistics are currently available from the CDC for 1999 through 2007.

In late February 2010 the Society for Assisted Reproductive Technology (SART) released the IVF Success Rate Report for 2008 cycles.

The SART report is released every year on the web and is available to the public. Almost all reputable in vitro fertilization centers are members of SART. Members are required to submit their in vitro fertilization data annually. Each clinic has its own listing page that shows its success rates on the SART website.

To view any clinic’s success rates through SART:

1. Go to the SART website
2. Click on IVF Success Rate Reports
3. On the map, click the state that you are interested in.
4. A list of all reputable SART member clinics in that state comes up.
5. Click on any individual clinic – a page called “Clinic Contact Information” appears. At the bottom click the link next to “ART Data Report”. You will go to a page showing that center’s in vitro fertilization success rates for 2008.
6. To see the center’s IVF statistics from a previous year, use the pulldown menu at the upper left where it says “Select Year”.

Although clinics with low success rates don’t mention it, there are large differences in success rates between clinics

There are number of reasons for this, but the biggest difference between different clinics is the degree of quality control within the system.

Patients often ask me why our success rates are so high. The answer is simple.

• We invest in the best technology and work hard to maintain ideal quality control
• It is much easier to do “average IVF” than it is to do “high quality IVF”
• High quality ovarian stimulation for IVF can result in better egg quality
• High quality embryo culture in the lab can result in better embryo quality
• High quality embryo transfer procedure to put them back in the uterus results in a higher chance for embryo implantation

Some clinics in the Chicago area tell patients that our success rates are high because of our “patient selection”. They say that “Dr. Sherbahn gets the easy cases” and that their center gets more of the difficult cases. This is absurd.

• After couples check success rates on the CDC or SART websites, they do not gravitate to clinics with low success rates.
• They do the exact opposite. They go to clinics with higher success rates – and avoid further treatment at clinics with low success rates.
  • The effect is that clinics with higher success rates get a mix of more difficult cases compared to clinics with low rates.
• The more times a couple has failed in vitro fertilization, the more likely they are to check success rates online to research their options.
  • Learn more about what to do if your first IVF cycle fails

So do your research before you do your IVF

Look up the live birth success rates on the SART or CDC sites and make an informed choice – before your first cycle. I suggest that you trust your in vitro fertilization cycle to a clinic with success rates at or above the national average.

A comparison of clinic success rates may not be meaningful because patient medical characteristics, treatment approaches and entrance criteria for ART may vary from clinic to clinic.

Richard Sherbahn, MD is a fertility doctor practicing in the Chicago, Illinois area. Connect with me on Google+

Mail | Web | Google+ | More Posts